获得性免疫缺陷综合征患者医院感染的病原菌分布与CD_4^+水平检测

Distribution of pathogens causing nosocomial infections in patients with acquired immunodeficiency syndrome and detection of CD_4^+ level

目的探讨获得性免役缺陷综合征患者医院感染的病原菌分布及CD4+水平,对临床诊治和预防提供参考,降低获得性免疫缺陷综合征患者医院感染率。方法选取2011年3月-2014年3月获得性免疫缺陷综合征患者240例,将发生感染的118例患者设为观察组,未发生感染的122例患者设为对照组,取感染部位体液进行病原菌培养,统计病原菌分布;抽取两组患者血液行CD4+水平检测;采用SPSS13.0软件进行分析。结果观察组118例患者共检出病原菌143株,其中革兰阳性菌87株占60.84%,革兰阴性菌53株占37.06%,真菌3株占2.10%;对照组患者CD4+水平0~100、101~200、201~300、301~400、>400个/ml者分别占0、4.1%、13.1%、20.5%和62.3%,观察组患者分别为25.4%、29.7%、24.6%、12.7%和7.6%,观察组患者CD4+水平明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论对于合并获得性免疫缺陷综合征的患者应积极预防,避免其发生医院感染;一旦发生感染,应早期给予抗菌药物治疗。

OBJECTIVE To explore the distribution of the pathogens causing nosocomial infections in the patients with acquired immunodeficiency syndrome and detect the level of CD4^＋so as to provide guidance for clinical diagnosis and treatment and to reduce the incidence of nosocomial infections in the patients with acquired immunodeficiency syndrome.METHODS A total of 240 patients with acquired immunodeficiency syndrome who were treated in the hospital from Mar 2011 to Mar 2014 were enrolled in the study,of whom 118 cases with infections were assigned as the observation group,and 122 cases without infections were set as the control group.The body fluid specimens were collected from the infection sites for the culture of pathogens,and the isolated pathogens were statistically analyzed;the blood was extracted for the detection of CD4^＋level;the statistical analysis was performed with the use of SPSS13.0software.RESULTS Totally 143 strains of pathogens were isolated from the 118 patients in the observation group,including 87（60.84%）strains of gram-positive bacteria,37.06%（53strains）of gramnegative bacteria,and 3（2.10%）strains of fungi.The patients with the CD4^＋level ranging between 0and 100cells/ml accounted for 0in the control group,25.4%in the observation group;the patients with the CD4^＋level ranging from 101 to 200cells/ml accounted for 4.1%in the control group,29.7%in the observation group;the patients with the CD4^＋level ranging from 201 to 300cells/ml accounted for 13.1%in the control group,24.6%in the observation group;the patients with the CD4^＋level ranging from 301 to 400cells/ml accounted for 20.5%in the observation group,12.7%in the observation group;the patients with the CD4^＋level more than 400cells/ml accounted for 62.3%in the control group,7.6%in the observation group;the levels of CD4^＋of the observation group were significantly lower than those of the control group（P〈0.05）.CONCLUSIONIt is necessary to actively take the measures to prevent the nosocomial infections in the patients with acquired immunodeficiency syndrome.The drug therapy should be conducted in early stage once the infections occur.